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Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed to compare the analgesic efficacy and safety of paracetamol, diclofenac, and ketorolac when used after appendectomy and to assess their efficacy regarding nausea and vomiting in children and adolescents. A randomized, single-blinded, comparative, observational prospective clinical study was carried out on patients diagnosed with acute appendicitis and assigned for emergent appendectomy between October 2018 to May 2019 in Al- Zahraa Teaching Hospital in Al-Najaf province, Iraq.120 patients were randomly distributed into three groups who received diclofenac sodium suppositories (2mg/kg), IV Paracetamol )15mg/ kg every 6 hr.(, and IV  Ketorolac )0.5mg/ kg( immediately after surgery. All patients were observed for pain, nausea and vomiting and bleeding. Patients received ketorolac had a high percentage of the decrease in pain score between 30 and 60 min. after surgery, while paracetamol was the next and diclofenac sodium was the last. Regarding nausea and vomiting after surgery, ketorolac had higher percentage of the decrease in nausea, vomiting score during first day after surgery followed by diclofenac and paracetamol respectively. The present study also showed that there is no significant difference between groups regarding bleeding after surgery. It is concluded that ketorolac has higher analgesic efficacy compared with paracetamol and diclofenac with no risk of nausea and vomiting and bleeding when used after appendectomy.

Keywords: Postoperative pain, Ketorolac, Diclofenac, Paracetamol, Appendectomy.

 

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Publication Date
Sat Dec 20 2014
Journal Name
International Journal Of Current Engineering And Technology
The Effect of Sb Dopant and Annealing Temperature on the Structural and Optical Properties of GeSe Thin Films
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The pure and Sb doped GeSe thin films have been prepared by thermal flash evaporation technique. Both the structural and optical measurement were carried out for as deposited and annealed films at different annealing temperatures.XRD spectra revealed that the all films have one significant broad amorphous peak except for pure GeSe thin film which annealed at 573 K, it has sharp peak belong to orthorhombic structure nearly at 2θ=33o . The results of the optical studies showed that the optical transition is direct and indirect allowed. The energy gap in general increased with increasing annealing temperature and decreased with increase the ratio of Sb dopant. The optical parameters such as refractive index, extinction coefficient and r

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Publication Date
Wed Nov 24 2021
Journal Name
International Journal Of Differential Equations
The Impact of Media Coverage and Curfew on the Outbreak of Coronavirus Disease 2019 Model: Stability and Bifurcation
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In this study, the spreading of the pandemic coronavirus disease (COVID-19) is formulated mathematically. The objective of this study is to stop or slow the spread of COVID-19. In fact, to stop the spread of COVID-19, the vaccine of the disease is needed. However, in the absence of the vaccine, people must have to obey curfew and social distancing and follow the media alert coverage rule. In order to maintain these alternative factors, we must obey the modeling rule. Therefore, the impact of curfew, media alert coverage, and social distance between the individuals on the outbreak of disease is considered. Five ordinary differential equations of the first-order are used to represent the model. The solution properties of the system ar

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Administrative coordination between the Federal Ministry and the local government and its impact on municipal performance An applied study in the municipalities of Dhi Qar Governorate
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       The aim of the research is to show the extent of the impact of administrative coordination on municipal performance after the state’s tendency to implement administrative decentralization and transfer of powers (administrative, legal, financial, and technical) from the Federal Ministry (construction, housing, municipalities, and public works) to local governments (governorates), to meet local needs, And since the municipality is considered one of the local administrative institutions and most of its goal is to provide increased municipal services to citizens due to population growth and urban expansion of cities by coordinating their actions using their powers, and in order to address gaps i

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Political Marketing and the Formation of Trends in Public Opinion on Social Networking Sites: An Analytical Study of the Two F.B. Pages: the Prime Minister and the Parliament President
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The social networking sites have become one of the most important promotional instruments for their characteristic of facilitation of communication and the creation of public platform for discussion and formation of new points of view. These sites were used in the political marketing process where politicians use Facebook pages to promote their ideologies and spread their programs for the purpose of an influencing public opinion.
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Publication Date
Mon Jan 02 2023
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Scripta Medica
The influence of socioeconomic status and general health on the fracture incidence
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Background/Aim There is an association between patient general health, socioeconomic status and fracture incidence. Aim of this study was to demonstrate the relation between the socioeconomic and health status and the occurrence of fractures in Al-Kindy Hospital residents. Methods A prospective cross-sectional study was performed by using data collected from fractured patients in Al-Kindy Teaching Hospital / Baghdad Orthopaedics Outpatient Clinic, between 12 December 2021 and 8 March 2022. A hundred patients aged 20 to 75 years were included in this study. The data were collected using a researcher-administered questionnaire, which included items to assess patient's socioeconomic status (accommodations, occupation, income status, level of e

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Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
On the design of the annexation experience between splintered and dissociated sectors
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design

formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application   to show its idia and the ability to use it in many fields  especially in agricultural experiments field .

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Publication Date
Thu Dec 19 2019
Journal Name
مجلة العلوم النفسية
Employment of the Roundhouse Strategy and its Impact on Academic Achievement and Core Thinking
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The aim of this research is to employ the roundhouse strategy to study its impact on the students achievement of the 10th grade in physics and their core thinking. After the application of the research experience and gaining data, which was processed statistically using the statistical packages program (SPSS). The results of the researcher revealed the superiority of the students of the experimental group who studied using the roundhouse strategy on the students of the control group who studied the usual method in the achievement test. As results showed that there were statistically significant differences between the average scores of the experimental group and the average scores of the control group students in the core thinking test and

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Illiteracy and its Impact on the Reality of Iraqi Youth between Heritage and Contemporary
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Illiteracy has spread in the last years, although it was eliminated in the 1980s. The return of illiteracy brings ignorance, illness, backwardness and regression among nations. It has taken many types, mainly alphabetical, scientific and computer illiteracy. Hence, the increasing nature of illiteracy has attracted the attention of governments and societies alike. This may touch the reality of societies starting with their youth unless those, who are in charge, will find workable solutions for the existing problems. The results of the study revealed that there is a real disaster awaiting the next generation after years of stray, and ignorance of the people in charge who are too engaged in getting their privileges to care about this proble

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Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the

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Publication Date
Tue Jul 14 2015
Journal Name
Ibn Al-haitham J. For Pure & Appl. Sci.
Effect of Annealing Temperature and Thickness on the Structural and Optical Properties of CdSeThin Films
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CdSe alloy has been prepared successfully from its high purity elements. Thin films of this alloy with different thicknesses (300,700)nm have been grown on glass substrates at room temperature under very low pressure (10-5)Torr with rate of deposition (1.7)nm/sec by thermal evaporation technique, after that these thin films have been heat treated under low pressure (10-2)Torr at (473,673)K for one hour. X-ray patterns showed that both CdSe alloy and thin films are polycrystalline and have the hexagonal structure with preferential orientation in the [100] and [002] direction respectively. The optical measurements indicated that CdSe thin films have allowed direct optical energy band gap, and it increases from (1.77- 1.84) eV and from

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